I feel compelled to add here that I had my Sarpe surgery in Costa Rica for 3200, and will be having a BSSO, Lefort I and geniplasty for 6k--this includes surgeon fees plus one night in the hospital. W/ the airfare and two week stay at a recovery retreat it should come out to about 8k.
I was very pleased with the care I received from my OMS for my Sarpe, and my ortho was pleased with the operation's outcome.
INSANE HOSPITAL FEES!!!!
Moderator: bbsadmin
-
4beauty4symmetry
- Posts: 226
- Joined: Thu Nov 16, 2006 5:58 pm
- Location: boston
Dec 2006--RPE followed by SARPE surgery
Jan 2007--Braces
Nov 2007 BSSO mandibular setback, genioplasty, and two implant anchors. Surgery-eve reprieve from Lefort.
May 2008--Debraced
Surgeries in Costa Rica, Orthodontics in Massachusetts.
All to fix an openbite, crossbite, underbite, and two missing bottom molars.
Jan 2007--Braces
Nov 2007 BSSO mandibular setback, genioplasty, and two implant anchors. Surgery-eve reprieve from Lefort.
May 2008--Debraced
Surgeries in Costa Rica, Orthodontics in Massachusetts.
All to fix an openbite, crossbite, underbite, and two missing bottom molars.
Beware meddling dentists...
Broochie,
I read your post and couldn't believe how similar our situations are. The first advice I can offer is DISREGARD most of what your dentist says about who is a qualified surgeon and who isn't. Your dentist thinks there isn't more than two or three qualified surgeons in Canada? Gimme a break. Your dentist has other considerations on his/her mind than just your health.
Here's a little background about my situation. I initially started my orthognathic journey about three years ago when my dentist noticed I'd worn off a lot of tooth enamel on my molars. Even though he'd been my dentist since childhood, suddenly he noticed the wear on my teeth and was very concerned, eventually suggesting I consider corrective jaw surgery. I spent about three to four months researching various procedures, thinking about the cost, checking with my insurance and weighing the pros and cons. I eventually decided to go ahead with the whole process. I met with my dentist who suggested I have several expensive Xrays that I had to pay for out-of-pocket and I agreed. These Xrays only reinforced my need for jaw surgery. Then my dentist recommended I have an MRI of my temporomandibular joints (TMJ) to make sure they could withstand the stress of jaw surgery. Well, my TMJ joints weren't in optimal shape but they've never caused me any pain or locking in my jaw. Now my dentist is adamant I have TMJ joint surgery with some doctor on the other side of the country who doesn't take insurance, charges $60,000 in professional fees alone and performs some procedure that the oral/maxillofacial community at large still considers experimental. I never once said I was even remotely interested in this surgeon or his procedure, but my dentist refused to refer me to any other surgeon. I eventually scheduled a consult with an orthodontist whom my dentist recommended and this orthodontist created a treatment plan to culminate with jaw surgery (NOT joint surgery). I was all ready to go when my orthodontist informed me he wanted to wait on beginning treatment until he could meet with the joint surgeon my dentist was obsessed with at some special conference in eight months. I was really angry, but acquiesced, thinking if they both felt so strongly about this, surely they must know something I don't. Nine months passed and I called to get the results of their meeting and was told, "Oh that conference? That was canceled due to low enrollment." WHAT? Why wasn't I informed and how long had they known it was canceled? After this I was fed up and told my dentist I was making appointments with maxillofacial surgeons in the area on my own to receive some consults and/or second opinions. He pleaded with me to let the TMJ joint surgeon at least review my medical records/Xrays and give me a report on his findings. Again, against my better judgment, I acquiesced. The TMJ joint surgeon's office lost my records, then found them, then fired their office manager, then changed transcription companies and finally gave me my report (which I paid $350 for out-of-pocket) eight months later. EIGHT months for a two page report that concluded nothing that we didn't already know. I'd finally had it and scheduled the consults with the surgeons I wanted on my own. Now it's almost three years later, I still don't even have a surgery date scheduled, my orthodontist (the same one from earlier) can't stick to a timeline on when I'll be ready for surgery and now I have to start all over with my insurance company because during all the delays caused by my dentist, my employer downgraded their health benefits and are now trying to deny my surgery after I've spent $5800 on braces and over $4000 in out-of-pocket expenses for numerous consults, Xrays, MRIs, Tomographs, study models and cephalograms. The good news? Well, I don't have much except for my surgeon is the department head of oral/maxillofacial surgery at UCLA. So when my dentist tried to tell me there wasn't any surgeon in this area that wouldn't butcher me, that's a load of garbage. My dentist had other motives than my health for delaying my treatment two years. Those motives? I don't know. Maybe he wanted to get his name in some medical journals by attaching himself to that experimental TMJ surgeon vicariously through my treatment? Maybe he was listening to my father (who's been his friend since childhood) and my father's requests to thwart my progress at all costs even though I am an adult (28 years old) and it is illegal for a medical professional to discuss treatment with anyone except a minor's parent or legal guardian. All I do know is that there are lot's of good surgeon's out there, you just have to look...and you shouldn't have to fly to Alabama and pay America's exorbitant prices for health care.
I read your post and couldn't believe how similar our situations are. The first advice I can offer is DISREGARD most of what your dentist says about who is a qualified surgeon and who isn't. Your dentist thinks there isn't more than two or three qualified surgeons in Canada? Gimme a break. Your dentist has other considerations on his/her mind than just your health.
Here's a little background about my situation. I initially started my orthognathic journey about three years ago when my dentist noticed I'd worn off a lot of tooth enamel on my molars. Even though he'd been my dentist since childhood, suddenly he noticed the wear on my teeth and was very concerned, eventually suggesting I consider corrective jaw surgery. I spent about three to four months researching various procedures, thinking about the cost, checking with my insurance and weighing the pros and cons. I eventually decided to go ahead with the whole process. I met with my dentist who suggested I have several expensive Xrays that I had to pay for out-of-pocket and I agreed. These Xrays only reinforced my need for jaw surgery. Then my dentist recommended I have an MRI of my temporomandibular joints (TMJ) to make sure they could withstand the stress of jaw surgery. Well, my TMJ joints weren't in optimal shape but they've never caused me any pain or locking in my jaw. Now my dentist is adamant I have TMJ joint surgery with some doctor on the other side of the country who doesn't take insurance, charges $60,000 in professional fees alone and performs some procedure that the oral/maxillofacial community at large still considers experimental. I never once said I was even remotely interested in this surgeon or his procedure, but my dentist refused to refer me to any other surgeon. I eventually scheduled a consult with an orthodontist whom my dentist recommended and this orthodontist created a treatment plan to culminate with jaw surgery (NOT joint surgery). I was all ready to go when my orthodontist informed me he wanted to wait on beginning treatment until he could meet with the joint surgeon my dentist was obsessed with at some special conference in eight months. I was really angry, but acquiesced, thinking if they both felt so strongly about this, surely they must know something I don't. Nine months passed and I called to get the results of their meeting and was told, "Oh that conference? That was canceled due to low enrollment." WHAT? Why wasn't I informed and how long had they known it was canceled? After this I was fed up and told my dentist I was making appointments with maxillofacial surgeons in the area on my own to receive some consults and/or second opinions. He pleaded with me to let the TMJ joint surgeon at least review my medical records/Xrays and give me a report on his findings. Again, against my better judgment, I acquiesced. The TMJ joint surgeon's office lost my records, then found them, then fired their office manager, then changed transcription companies and finally gave me my report (which I paid $350 for out-of-pocket) eight months later. EIGHT months for a two page report that concluded nothing that we didn't already know. I'd finally had it and scheduled the consults with the surgeons I wanted on my own. Now it's almost three years later, I still don't even have a surgery date scheduled, my orthodontist (the same one from earlier) can't stick to a timeline on when I'll be ready for surgery and now I have to start all over with my insurance company because during all the delays caused by my dentist, my employer downgraded their health benefits and are now trying to deny my surgery after I've spent $5800 on braces and over $4000 in out-of-pocket expenses for numerous consults, Xrays, MRIs, Tomographs, study models and cephalograms. The good news? Well, I don't have much except for my surgeon is the department head of oral/maxillofacial surgery at UCLA. So when my dentist tried to tell me there wasn't any surgeon in this area that wouldn't butcher me, that's a load of garbage. My dentist had other motives than my health for delaying my treatment two years. Those motives? I don't know. Maybe he wanted to get his name in some medical journals by attaching himself to that experimental TMJ surgeon vicariously through my treatment? Maybe he was listening to my father (who's been his friend since childhood) and my father's requests to thwart my progress at all costs even though I am an adult (28 years old) and it is illegal for a medical professional to discuss treatment with anyone except a minor's parent or legal guardian. All I do know is that there are lot's of good surgeon's out there, you just have to look...and you shouldn't have to fly to Alabama and pay America's exorbitant prices for health care.
My goodness SleazyG,
What a time you've have to contend with! A very patient patient.... I do think that we all have to take charge of our own treatment. I have found that I need to call and ask for what I want, and then call again. I know these specialty doctors are very busy and they can't guarantee when you'll be ready for surgery, but then why take you on as a patient and what's up with the two year run around!?!?. It is, after all, your money (so far) that's been spent.
I told my Ortho and OS that I was going on vacation out of the country the end of August and wanted sugery (I knew I was close - braces for 14 months) at the latest by the middle of July. They scheduled me for June 30th - pending insurance approval. Unfortunately, I think it's true that the squeaky wheel gets the grease. And sometimes I have to be pretty squeaky
- but I don't intend to wear braces forever! This is my second time around and I'm also quite a bit older than you.
You'd think your own doctors would look out for you and your schedule a bit more, but being too easy to get along hasn't worked for me!
Good luck on getting your surgery as soon as possible.
Lo
What a time you've have to contend with! A very patient patient.... I do think that we all have to take charge of our own treatment. I have found that I need to call and ask for what I want, and then call again. I know these specialty doctors are very busy and they can't guarantee when you'll be ready for surgery, but then why take you on as a patient and what's up with the two year run around!?!?. It is, after all, your money (so far) that's been spent.
I told my Ortho and OS that I was going on vacation out of the country the end of August and wanted sugery (I knew I was close - braces for 14 months) at the latest by the middle of July. They scheduled me for June 30th - pending insurance approval. Unfortunately, I think it's true that the squeaky wheel gets the grease. And sometimes I have to be pretty squeaky
- but I don't intend to wear braces forever! This is my second time around and I'm also quite a bit older than you. You'd think your own doctors would look out for you and your schedule a bit more, but being too easy to get along hasn't worked for me!
Good luck on getting your surgery as soon as possible.
Lo
HighandLo,
Your advice couldn't be any more true or pertinent! What is it with these doctors and their staff where they treat the patient as an unreasonable nuisance? They don't want to hear your concerns and they don't want to be bothered returning your calls in a timely manner. My situation has actually been much worse than my initial post, but I didn't want to enumerate on everything that has gone awry as this is Broochie's topic and I just wanted to suggest that a patient should never let one physician entirely control their treatment. Physicians should be able to work with a wide array of their colleagues. But, what you said is absolutely correct. You HAVE to take charge of your own treatment, especially with orthognathic surgery. Here in the USA, I've found it really hard to find anyone who cares about the patient when it concerns preventative treatment, which orthognathic surgery is. I mean, it's not like any of us will die in three months if we don't have surgery, so these physicians think this is strictly low-priority stuff. Health care in the USA may be great if you're literally bleeding from every orifice, but try and get something taken care of before it causes you major bodily harm and good luck. I've also found that physicians think these cases exist in a vacuum where you'll just discard any aspect of your life that doesn't fit in with their treatment plan. Well, we have jobs, spouses, children, financial commitments, sick parents and plenty of other responsibilities that need to be taken into account. Yes, we want surgery, but not at any cost to our personal lives. So...one must be prepared to make a lot of phone calls, wait on-hold for half-hours, write letters, call the same office once everyday and oddly enough, work on being curt and rude...for some reason, it's all some people respond to. Being the nice guy gets you nowhere. I have the last two and a half years to prove it. It'll make you feel like a total jerk/psycho, but sometimes you just need to be the one they want to get rid of.
Your advice couldn't be any more true or pertinent! What is it with these doctors and their staff where they treat the patient as an unreasonable nuisance? They don't want to hear your concerns and they don't want to be bothered returning your calls in a timely manner. My situation has actually been much worse than my initial post, but I didn't want to enumerate on everything that has gone awry as this is Broochie's topic and I just wanted to suggest that a patient should never let one physician entirely control their treatment. Physicians should be able to work with a wide array of their colleagues. But, what you said is absolutely correct. You HAVE to take charge of your own treatment, especially with orthognathic surgery. Here in the USA, I've found it really hard to find anyone who cares about the patient when it concerns preventative treatment, which orthognathic surgery is. I mean, it's not like any of us will die in three months if we don't have surgery, so these physicians think this is strictly low-priority stuff. Health care in the USA may be great if you're literally bleeding from every orifice, but try and get something taken care of before it causes you major bodily harm and good luck. I've also found that physicians think these cases exist in a vacuum where you'll just discard any aspect of your life that doesn't fit in with their treatment plan. Well, we have jobs, spouses, children, financial commitments, sick parents and plenty of other responsibilities that need to be taken into account. Yes, we want surgery, but not at any cost to our personal lives. So...one must be prepared to make a lot of phone calls, wait on-hold for half-hours, write letters, call the same office once everyday and oddly enough, work on being curt and rude...for some reason, it's all some people respond to. Being the nice guy gets you nowhere. I have the last two and a half years to prove it. It'll make you feel like a total jerk/psycho, but sometimes you just need to be the one they want to get rid of.
-
lemartines
- Posts: 5
- Joined: Thu Sep 07, 2006 4:02 pm
- Location: Los Angeles, CA
I am appalled by this thread. It's a wake up call for patients and all professionals involved in orthodontic/oral surgery care. I'm a young orthodontist and have done very few surgical cases. Coincidentally, I was speaking with a referring general dentist today on the topic of selecting a good oral surgeon to work with. I do see how some of the "more experienced" dentists, orthodontists and oral surgeons work in a cartel-like manner that sometimes overlooks patient care. I hope some of my colleagues will read this and possibly learn from it.
I'm no saint myself and have fallen prey to poor communication with patients at times. I do, however, tell my patients that are considering orthognathic surgery that if they do not have insurance that covers such procedure, that other treatment options (no treatment among them) should be considered. Especially in SoCal where healthcare is ridiculously expensive.
Good luck broochie. It's insane to think there are no qualified oral surgeons in Montreal or in Canada.
I'm no saint myself and have fallen prey to poor communication with patients at times. I do, however, tell my patients that are considering orthognathic surgery that if they do not have insurance that covers such procedure, that other treatment options (no treatment among them) should be considered. Especially in SoCal where healthcare is ridiculously expensive.
Good luck broochie. It's insane to think there are no qualified oral surgeons in Montreal or in Canada.
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lemartines
- Posts: 5
- Joined: Thu Sep 07, 2006 4:02 pm
- Location: Los Angeles, CA
I am in total agreement with youagree. It is totally acceptable that professionals work with referrals they trust.
It just blew me away that this one patient from Canada had to seek opinions from oral surgeons all the way from Alabama and California after being told there are no qualified ones in his city (a big city) and country. That's a bit hard to accept.
It just blew me away that this one patient from Canada had to seek opinions from oral surgeons all the way from Alabama and California after being told there are no qualified ones in his city (a big city) and country. That's a bit hard to accept.
Thanks to everybody for their answers, and sorry for answering so late. I was out of town for few days and couldn’t get my hands on a computer.
Thanks angelgarcia for your input. I might try to investigate those docs.
Ohmyjaw, thanks again. Well BC is not exactly next door, but it’s still Canada
Meryaten has already answered your question. Yes, impaction of the upper jaw means shortening it to correct a gummy smile.
4beauty4symmetry, it seems like more and more people go to Costa Rica for oral and cosmetic surgery procedures. Indeed it is a lot cheaper (and the country is beautiful) but I would consider it too risky in my case. Anyway, congrats for your SARPE and good luck for the upcoming LeFort, BSSO and genioplasty.
SleazyG,
Your story is appalling, how rude and inconsiderate these professionals are sometimes ! I am sorry to hear that you have lost so much time and money in the process, this is outrageous. Hang in there ! Anyway, you are right and société is HighandLo, week-end have to take charge of our own treatments, now I am definitely convinced of that !
Lemartines
It’s nice to hear that a professional reads this and understands. I wish more of your colleagues did. Yes I am sure there are skilled oral surgeons in Canada. The crazy thing is I have to do almost a police investigation to find one, or ask my fellow Archwired members, instead of being referred by a professional.
Okay, so here is the follow-up on my story. Yesterday I had another appointment with oral surgeon #4, who had asked to see me again after he has thought about my case (the first time, he saw me kind of quickly at the hospital, as a courtesy to my ortho). His conclusions are :
- Impaction of the upper jaw (LeFort 1) : I am definitely too old for the surgery, I might lose my upper molars because the blood flow would be impaired for some time after surgery.
-
- For the lower jaw (BTW, he thinks the Alabama oral surgeon is crazy to call for a 4 millimeters impaction without BSSO. He says that beyond 1 or 2 millimeters of impaction, if there is no BSSO, there will be too much discrepancy between both jaws). Anyway, due to my age, I might have long-lasting or permanent loss of feeling in the chin and lower lip, leading to difficulty putting lipstick on, drinking from a glass, etc.
- Genioplasty would be okay in my case, when all orthodontic work is complete. In his words, « the icing on the cake ».
I would like to say that although I am 47, I don’t smoke, exercise regularly, eat healthy, I am thin, no history of diabetes, high blood pressure, cholesterol or heart problems. But he sure made me feel as if I was 100 years old ?(
So here is his « plan B » : lessening the gum tissue on the upper jaw by further lenghtening the teeth (which are already too big) vertically, then re-creating a less gummy smile with veneers.
Needless to say this procedure doesn’t sound good to me at all, and far more invasive than LeFort. If he is already worried about my losing teeth, how healthy is it to remove some of the gum tissue that attaches them to the jaw and bearing more of the bone which in his own opinion is already too thin ?
Bottom line : this is not the route to go. Anyway, your answers have all convinced me that I should keep looking. The good news is, since my ortho thinks I am not ready yet for surgery, it gives me some time to keep looking.
BTW, I have a good friend in Atlanta, I could stay with her after surgery and save on hotel costs. Any referrals would be welcome. Thanks again to you all, thanks to your support I am not totally going insane.
Thanks angelgarcia for your input. I might try to investigate those docs.
Ohmyjaw, thanks again. Well BC is not exactly next door, but it’s still Canada
Meryaten has already answered your question. Yes, impaction of the upper jaw means shortening it to correct a gummy smile.
4beauty4symmetry, it seems like more and more people go to Costa Rica for oral and cosmetic surgery procedures. Indeed it is a lot cheaper (and the country is beautiful) but I would consider it too risky in my case. Anyway, congrats for your SARPE and good luck for the upcoming LeFort, BSSO and genioplasty.
SleazyG,
Your story is appalling, how rude and inconsiderate these professionals are sometimes ! I am sorry to hear that you have lost so much time and money in the process, this is outrageous. Hang in there ! Anyway, you are right and société is HighandLo, week-end have to take charge of our own treatments, now I am definitely convinced of that !
Lemartines
It’s nice to hear that a professional reads this and understands. I wish more of your colleagues did. Yes I am sure there are skilled oral surgeons in Canada. The crazy thing is I have to do almost a police investigation to find one, or ask my fellow Archwired members, instead of being referred by a professional.
Okay, so here is the follow-up on my story. Yesterday I had another appointment with oral surgeon #4, who had asked to see me again after he has thought about my case (the first time, he saw me kind of quickly at the hospital, as a courtesy to my ortho). His conclusions are :
- Impaction of the upper jaw (LeFort 1) : I am definitely too old for the surgery, I might lose my upper molars because the blood flow would be impaired for some time after surgery.
-
- For the lower jaw (BTW, he thinks the Alabama oral surgeon is crazy to call for a 4 millimeters impaction without BSSO. He says that beyond 1 or 2 millimeters of impaction, if there is no BSSO, there will be too much discrepancy between both jaws). Anyway, due to my age, I might have long-lasting or permanent loss of feeling in the chin and lower lip, leading to difficulty putting lipstick on, drinking from a glass, etc.
- Genioplasty would be okay in my case, when all orthodontic work is complete. In his words, « the icing on the cake ».
I would like to say that although I am 47, I don’t smoke, exercise regularly, eat healthy, I am thin, no history of diabetes, high blood pressure, cholesterol or heart problems. But he sure made me feel as if I was 100 years old ?(
So here is his « plan B » : lessening the gum tissue on the upper jaw by further lenghtening the teeth (which are already too big) vertically, then re-creating a less gummy smile with veneers.
Needless to say this procedure doesn’t sound good to me at all, and far more invasive than LeFort. If he is already worried about my losing teeth, how healthy is it to remove some of the gum tissue that attaches them to the jaw and bearing more of the bone which in his own opinion is already too thin ?
Bottom line : this is not the route to go. Anyway, your answers have all convinced me that I should keep looking. The good news is, since my ortho thinks I am not ready yet for surgery, it gives me some time to keep looking.
BTW, I have a good friend in Atlanta, I could stay with her after surgery and save on hotel costs. Any referrals would be welcome. Thanks again to you all, thanks to your support I am not totally going insane.
Broochie,
Well, I don't think you are insane! It is mind-boggling to hear all the differing opinions on your treatment. My OS thinks he can get away with just doing lower jaw surgery - I am waiting to hear the particulars this week after he and my Ortho look at the models. I have a crossbite and asymmetry and a few too many teeth removed from my lower jaw.
I am in much the same boat as you. I also don't smoke or drink much (wine is OK by me!), I am slim, walk each day, take vitamins, eat right, etc. And I am also 47 and my doctors have not breathed a word about my being too old (or infirm) for surgery. Maybe it's in my chart in bold letters, but they haven't spoken of it!
I do feel for you and send positive thoughts your way to find a good doctor with an opinion you can trust. I wish I knew of a good doctor to recommend in your neck of the woods.
Lo
Well, I don't think you are insane! It is mind-boggling to hear all the differing opinions on your treatment. My OS thinks he can get away with just doing lower jaw surgery - I am waiting to hear the particulars this week after he and my Ortho look at the models. I have a crossbite and asymmetry and a few too many teeth removed from my lower jaw.
I am in much the same boat as you. I also don't smoke or drink much (wine is OK by me!), I am slim, walk each day, take vitamins, eat right, etc. And I am also 47 and my doctors have not breathed a word about my being too old (or infirm) for surgery. Maybe it's in my chart in bold letters, but they haven't spoken of it!
I do feel for you and send positive thoughts your way to find a good doctor with an opinion you can trust. I wish I knew of a good doctor to recommend in your neck of the woods.
Lo
-
lemartines
- Posts: 5
- Joined: Thu Sep 07, 2006 4:02 pm
- Location: Los Angeles, CA
Just wanted to clarefy the aspect of numbness on the lower lip (or of both lips) following an orthognathic surgery procedure. It is common that a transient, temporary numbness will occur in the first few post-surgical weeks. In general, over time, the sensibility will return. In some cases it takes longer (months, a year, sometimes 2 years) for full recovery of lip sensibility. There are, however, a few cases where different degrees of loss of sensibility is permanent.
This and other factors are usually addressed by the oral surgeon in the pre-surgical consultations.
This and other factors are usually addressed by the oral surgeon in the pre-surgical consultations.